1. Field of the Disclosure
This disclosure pertains generally to systems and methods for generating apertures in body tissues, and more particularly to systems and methods for generating apertures in vasculature.
2. Description of Related Art
Ventricular assist devices (VAD's) are mechanical circulatory devices that are used to partially or completely replace the function of a failing heart. Several continuous-flow ventricular assist devices (VADs) have been developed over the last decade. Compared with pulsatile-output predecessors, continuous-flow VADs are smaller, quieter, and easier to implant. Despite these advances, many patients still suffer significant morbidity or even death in association with the implantation procedure itself.
In conventional VAD implantation with cardiopulmonary bypass (CPB), normothermia is maintained and the heart continues to beat while a cylindrical blade excises a core of myocardium from the apex. A VAD sewing ring is then sutured to the margins of the apical hole.
Another technique is off-Pump VAD Implantation without CPB, such as that used for placement of a HeartMate® II LVAD (Thoratec Corporation; Pleasanton, Calif.). Typically, deep pericardial sutures or lap pads are used to facilitate this. In some instances, hemodynamic stability cannot be maintained, and CPB must be initiated.
Many existing procedures generally require one or more cardiac surgeons and rapid and risky exchanges between the surgeon's finger and knife or other instrument.
Accordingly, an object of the present disclosure is to provide tools and techniques to eliminate some of these steps and facilitate the creation of a clean circular hole without retained myocardial fragments.